BILL NUMBER: AB 1253	CHAPTERED  10/10/99

	CHAPTER   1025
	FILED WITH SECRETARY OF STATE   OCTOBER 14, 1999
	PASSED THE SENATE   SEPTEMBER 9, 1999
	PASSED THE ASSEMBLY   SEPTEMBER 9, 1999
	AMENDED IN SENATE   SEPTEMBER 8, 1999
	AMENDED IN SENATE   AUGUST 26, 1999
	AMENDED IN ASSEMBLY   APRIL 6, 1999

INTRODUCED BY   Assembly Member Nakano

                        FEBRUARY 26, 1999

   An act to add and repeal Chapter 8 (commencing with Section
124960) of Part 4 of Division 106 of the Health and Safety Code,
relating to health.

      e law without Governor's signature.  Filed with
Secretary of State October 14, 1999.)


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1253, Nakano.  Health services pilot program:  uninsured
working poor families.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Services, under which qualified
low-income persons are provided with health care services.  Existing
law also provides for the Healthy Families Program, and for the
Managed Risk Medical Insurance Board to administer the program.
   This bill would require the department to establish a 3-year pilot
program to provide health care services to certain uninsured poor
children and adults through a specified participating community care
clinic.  This bill would authorize the School of Public Health of the
University of California, Los Angeles, with the consent of the
Regents of the University of California, to participate in the pilot
program by developing an evaluation design and evaluating the pilot
program.  This bill would authorize the department, in consultation
with the participating community clinic, to appoint an advisory group
to provide assistance and advice to the pilot program.  This bill
would make its provisions inoperative on July 1, 2003, and would
repeal them as of January 1, 2004.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  (a) It is the intent of the Legislature to establish a
pilot program that will team community clinics with local hospitals,
small employers, and the School of Public Health of the University of
California, Los Angeles, to create a complete system of health care
for poor children and adults who are ineligible for public health
programs or private health plans or insurance.
   (b) The purpose of the pilot program is to accomplish all of the
following:
   (1) To demonstrate the potential for profound reductions in the
cost of health care services provided to uninsured working poor
families by tracking the cost of the care and the impact of access to
care on those families.
   (2) To achieve a better understanding of the overall social and
financial implications of moving uninsured working poor families to a
fully covered status.
   (3) To learn what the baseline utilization of health care services
is for uninsured working poor families when they have access to a
full range of health care services.
   (4) To learn the actual cost of providing comprehensive health
care to this population.
   (5) To learn how a managed care system for uninsured working poor
families might be used to change the structure of health care
delivery in California.
  SEC. 2.  Chapter 8 (commencing with Section 124960) is added to
Part 4 of Division 106 of the Health and Safety Code, to read:

      CHAPTER 8.  HEALTH PILOT PROGRAM FOR WORKING POOR FAMILIES

   124960.  The department shall establish and administer a
three-year pilot program to provide health care services to poor
children and adults, who are not eligible for public or private
health coverage.
   124961.  The pilot program shall be implemented through the
participation of the community health clinic known as the Venice
Family Clinic.
   124962.  The participating community clinic shall do all of the
following:
   (a) On or before June 30, 2000, enter into an agreement with a
local partner hospital to implement the pilot project.
   (b) On or before June 30, 2000, with the consultation and
assistance of the department, and with the participation of its local
hospital partner, develop a managed health care delivery system to
provide to uninsured poor children and adults a standard health
benefit package that meets the requirements of Section 124964,
including, but not limited to, primary and preventive health care
services, specialty health care services, emergency health care
services, inpatient hospital services, laboratory, radiological, and
other diagnostic services, and medications related to all of these
health services.
   (c) On or before June 30, 2000, with the consultation and
assistance of the department, develop recruitment and enrollment
materials and procedures.
   (d) On or before June 30, 2000, recruit, hire and train staff,
conduct outreach to small employers in order to enroll poor children
and adults into the pilot program, and collect baseline data.
   (e) Commencing July 1, 2000, enroll approximately 350 uninsured
poor children and adults and begin providing health care services.
   (f) Utilize managed care principles, including utilization review
and quality assurance, in operating the system.
   124963.  By January 1, 2001, each participating community clinic
shall have its pilot program in full operation, and shall conduct
ongoing data collection and analysis for the duration of the pilot
program.
   124964.  The standard health benefit package provided to the
uninsured poor children and adults enrolled in the pilot program
shall be the same as, or comparable to, the benefit packages
available to the employees of those public agencies who have elected
to have their employees participate in the Public Employees' Medical
and Hospital Care Act, Part 5 (commencing with Section 22751) of
Division 5 of Title 2 of the Government Code.
   124965.  The School of Public Health of the University of
California, Los Angeles may, with the consent of the Regents of the
University of California, participate in the pilot program by doing
the following:
   (a) On or before June 30, 2000, develop an overall evaluation
design for the pilot program, including, but not limited to, methods
for evaluating the quality of care provided, measuring the impact on
public health, and assessing the health outcomes of participants.
   (b) On or before March 30, 2003, prepare an evaluation of the
pilot program and a financial analysis that includes the amounts
expended by the program in each year of operation and for what
purposes expenditures were made.
   124966.  The department may, in consultation with the
participating community clinic, appoint a small business and health
care industry advisory group to provide assistance and advice to the
pilot program.
   124967.  This chapter shall be implemented only to the extent
funding is made available by the Legislature.  It is the intent of
the Legislature that no more than three hundred seventy-five thousand
dollars ($375,000) be appropriated for the purpose of implementing
this chapter.
   124968.  This chapter shall become inoperative on July 1, 2003,
and, as of January 1, 2004, is repealed, unless a later enacted
statute that is enacted before January 1, 2004, deletes or extends
the dates on which it becomes inoperative and is repealed.
